Prognostic Value of NT-proBNP in Patients Undergoing Tricuspid Valve Transcatheter Edge-to-Edge Repair

BACKGROUND: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is an established marker of myocardial stress, yet its prognostic role in tricuspid valve transcatheter edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR) remains unclear. OBJECTIVES: The aim of this study was to evaluate the prognostic value of baseline NT-proBNP and its early postprocedural trajectory after T-TEER. METHODS: Patients undergoing T-TEER with available baseline NT-proBNP measurements in the EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation) registry were analyzed. NT-proBNP was evaluated continuously and by tertiles, with longitudinal changes assessed when serial measurements were available. Endpoints were the 2-year composite of all-cause mortality or first heart failure hospitalization, changes in NT-proBNP, symptomatic alleviation, and residual TR. RESULTS: increase: 0.63; 95% CI: 0.48-0.84; P < 0.001). Both baseline NT-proBNP and higher than expected 30-day levels relative to baseline were independently associated with higher subsequent risk for the primary endpoint. CONCLUSIONS: Baseline NT-proBNP was independently associated with 2-year mortality or heart failure hospitalization after T-TEER. Early postprocedural NT-proBNP trajectories provided incremental prognostic information and may identify patients at increased risk.